&lt;i&gt;Aspergillus versicolor&lt;/i&gt; Infection of the External Auditory Canal Successfully Treated with Terbinafine

Rotoli, M; Sascaro, Giuseppe; Cavalieri, Silvia

doi:10.1159/000051618

Cited by 18 publications

(9 citation statements)

References 5 publications

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“…In the literature only one study was found in which in vitro activity of itraconazole and terbinafine against Aspergillus species isolated from otomycosis, was tested. In this study, an external ear infection caused by A. versicolor and treated by giving systemic terbinafine was reported; MIC values of terbinafine and itraconazole against the etiologic strain were found as <0.125 and 0.5 μ g ml −1 respectively 3 . Apart from this, the outcomes of our study have been compared with previous studies determining in vitro antifungal activity against A. flavus , A. niger and A. terreus species in terms of the methods used the accepted MIC end‐points, the number of the isolates examined, the medium used for antifungal susceptibility, MIC reading periods, geometric means and MIC values.…”

Section: Discussionmentioning

confidence: 81%

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In vitro activity of terbinafine and itraconazole against Aspergillus species isolated from otomycosis

Karaarslan

Arıkan

Özcan

et al. 2004

Mycoses

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The minimum inhibitory concentrations (MIC, microg ml-1) of itraconazole and terbinafine against overall 34 Aspergillus isolates from the external ear canals with otomycosis have been determined with M38-P microdilution method suggested by National Committee for Clinical Laboratory Standards (NCCLS). MIC intervals in 48 h determined by taking MIC-2 value of itraconazole (the lowest drug concentration causing 50% inhibition of visible fungal growth) and MIC-0 value of terbinafine (the lowest drug concentration causing 100% inhibition of visible fungal growth) as a basis have been found as follows: 0.125-1 and 0.06-0.5 microg ml-1 for A. niger (22 strains), 0.06-0.25 and 0.06-0.125 microg ml-1 for A. flavus (10 strains), 0.125 and 0.125-0.5 microg ml-1 for A. terreus (two strains). It has been observed that both of the antifungal agents showed an in vitro activity against all Aspergillus species tested.

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Section: Discussionmentioning

confidence: 81%

“…Although there is not a certain treatment protocol, the general approach for the treatment of the disease is applying topical antifungal agents along with the cleaning of the external ear canal 2 . However, it is seen that sometimes systemic antifungal treatment is also applied 3 …”

Section: Introductionmentioning

confidence: 99%

In vitro activity of terbinafine and itraconazole against Aspergillus species isolated from otomycosis

Karaarslan

Arıkan

Özcan

et al. 2004

Mycoses

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“…[2][3][4]29 Oral azole antifungal medications are sometimes added for immunosuppressed patients and for cases of fungal otitis externa and otitis media refractory to topical medications alone, and in one case report, oral and topical terbinafine were used successfully to treat a case of external otomycosis due to Aspergillus versicolor. 5,10,18,20,28 A review of in vitro susceptibilities of 120 cases of human otomycosis associated with Aspergil-lus spp. revealed all isolates to be susceptible to both voriconazole and amphotericin B, and nine to be resistant to itraconazole.…”

Section: Discussionmentioning

confidence: 99%

Otomycosis due to Aspergillus spp. in a dog: case report and literature review

Coyner¹

2010

Veterinary Dermatology

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This report describes the clinical findings, clinicopathology and treatment of otomycosis caused by Aspergillus spp. in an atopic dog affected by chronic unilateral purulent otitis externa unresponsive to topical and oral antibiotics and antifungal treatments. Cytology of otic exudate revealed neutrophils and septate fungal hyphae, and otic culture grew Aspergillus spp. and no bacteria. Treatments included allergen-specific immunotherapy, topical and oral antifungal therapy and anti-inflammatory steroid therapy. Final resolution occurred after treatment of the underlying hypersensitivity disorder, administration of topical ketoconazole and debridement of infectious ear exudate. Otomycosis due to filamentous fungi may, as in humans, occur in dogs with ear canals compromised by pre-existing allergic or bacterial otitis, and possibly previous antibiotic therapy. Antifungal medications provided clinical improvement, but the key to successful treatment was the restoration of the normal physiology of the external auditory canal.

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“…Its efficacy, primarily fungicidal, against Aspergillus spp. has been widely demonstrated in vivo and in vitro in onychomycosis [34, 35, 36, 37, 38]and also in cases of refractory pulmonary aspergillosis [39]and aspergillosis of the external auditory canal [40]. In vitro it has been demonstrated to be more effective than amphotericin B and 5-flucytosine against different strains of Aspergillus spp.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Histological Aspects of Toenail Onychomycosis Caused by <i>Aspergillus</i> spp.: 34 Cases Treated with Weekly Intermittent Terbinafine

Gianni

Romano

2004

Dermatology

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Background: Non-dermatophytic onychomycoses represent 1.45–17.6% of all fungal nail infections. Epidemiological studies have shown that Aspergillus spp. are emerging fungal agents of toenail onychomycosis. Indeed, after Scopulariopsis spp. the genus Aspergillus is the second most common agent of non-dermatophytic onychomycosis. The diagnosis and treatment of toenail onychomycosis caused by non-dermatophyte moulds are not always straightforward. Objectives: The aims of this study were to describe the clinical appearance of toenail onychomycosis due to Aspergillus spp., to investigate the pathogenetic role of these agents and to evaluate the efficacy and safety of weekly intermittent terbinafine (500 mg/day for 1 week each month for 3 months) in the treatment of these patients. Patients and Methods: Mycological study of 2,154 patients with onychodystrophy revealed 1,228 onychomycoses (57%) including 71 cases due to non-dermatophytic fungi (5.6%). Non-dermatophytic onychomycosis caused by Aspergillus spp. represented 2.6% of all onychomycoses. The subjects were 34 patients (22 females, 12 males, age range 30–82 years) observed between September 1999 and December 2001, with toenail onychomycosis caused by Aspergillus spp. confirmed by standard techniques (microscopic examination and culture according to the criteria of English), histological examination of nail clippings and scanning electron microscope examination of the cultures whenever necessary. Results: The clinical features suggesting onychomycosis due to Aspergillus spp. are chalky deep white nail, rapid involvement of lamina and painful perionyxis without pus. Standard mycological tests (direct microscopy and fungal culture) and histological examination confirmed the pathogenetic role of Aspergillus spp. in onychomycoses. In particular, the histological examination was positive in 28 cases (82%) and useful in identifying typical aspects of Aspergillus spp. nail infections. At the follow-up, 12 months after the start of therapy with pulsed terbinafine, clinical and mycological recovery was confirmed in 30 of the 34 patients (88%). Conclusions: Treatment of non-dermatophytic onychomycosis with terbinafine usually requires at least 3 months of continuous systemic therapy. Our study of 34 patients confirms that terbinafine is particularly effective in the treatment of Aspergillus spp. nail infections and that a pulsed regimen is more economical and less demanding.

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<i>Aspergillus versicolor</i> Infection of the External Auditory Canal Successfully Treated with Terbinafine

Cited by 18 publications

References 5 publications

In vitro activity of terbinafine and itraconazole against Aspergillus species isolated from otomycosis

In vitro activity of terbinafine and itraconazole against Aspergillus species isolated from otomycosis

Otomycosis due to Aspergillus spp. in a dog: case report and literature review

Clinical and Histological Aspects of Toenail Onychomycosis Caused by <i>Aspergillus</i> spp.: 34 Cases Treated with Weekly Intermittent Terbinafine

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